The present disclosure relates to the inspection of surgical instrument lumen(s). More particularly, it relates to systems for inspection systems appropriate for use with the cleaning of a surgical instrument lumen, such as an endoscope lumen or channel, in a liquid (e.g., water) environment.
A plethora of different surgical instruments incorporate a tubular design in which one or more lumens or channels are utilized to facilitate caregiver interface with a target site inside the patient's body. For example, irrigation, suction, additional instrument(s), etc., are commonly delivered to an internal treatment site via the lumen(s) of a surgical instrument. Endoscopes are but one example of a surgical instrument providing at least one lumen (sometimes referred to as a “channel” in the context of endoscopes).
Regardless of exact form, under circumstances where the particular surgical instrument is intended and designed for repeated use, the instrument must be sterilized or high level disinfected prior to each use. Prior to the sterilization or high level disinfection, all debris and foreign matter must be removed from all surfaces of the instrument, both inside and out. In other words, the internal surfaces of the surgical instrument otherwise defining the instrument's lumen(s) must be cleaned.
Currently, the process after a procedure to clean a surgical instrument starts in the operating field. A surgical technician wipes the outside of the surgical instrument and flushes out the lumen(s) with sterile water or enzymatic solution (depending upon the procedure for which the surgical instrument was used). The next step is to manually clean the surgical instrument with an enzymatic solution in a decontamination or reprocessing area of the caregiver's facility. This process is performed at a sink filled with enzymatic solution. To clean surgical instrument lumen(s) (e.g., the lumen(s) or channel(s) of an endoscope), a technician inserts a brush into the lumen while submersed in the enzymatic solution. The technician manipulates the brush with back-and-forth and twisting motions, scrubbing debris and residue from the internal surfaces. With sufficient time and effort, this traditional cleaning technique can be effective in removing all debris from the lumen surfaces. However, the technician has no way of knowing in advance the time and effort required for a particular cleaning task as the physical constraints and type(s) of debris encountered vary widely. Moreover, because the lumen surfaces are internal or “hidden” relative to an exterior of an otherwise non-transparent surgical instrument (e.g., typically formed of surgical grade stainless steel or the like), the technician has no way of visually evaluating cleanliness of the lumen surfaces with the naked eye. It is exceedingly difficult to fully clean what the technician cannot see. An additional concern with traditional brush cleaning is that bristles of the brush may detach from the cleaning tool and problematically become lodged within the lumen.
Multiple surveys and clinical evaluations have documented that surgical instrument lumens (such as endoscopic channels) are still not fully clean following traditional cleaning. Most have reported that 60%-100% of lumens are still dirty when inspected following a traditional cleaning process.
Inspection tools are available for inspecting the surgical instrument lumen(s) following cleaning, and are generally in the form of a small diameter borescope.
While useful for evaluating cleaning efforts well after the technician has completed cleaning, borescope systems and complementary small diameter (2 mm or less) metal-oxide-semiconductor (CMOS) borescope systems promoted for surgical instrument inspection cannot be used at or during the time of cleaning due to the presence of liquid. Further, conventional CMOS borescope systems cannot be sterilized in a low temperature gas plasma sterilizer or high level disinfected.